Chalazion is a chronic granulomatous enlargement of a meibomian gland of the eyelid. This disorder is characterized by hypersecretion of meibum from the meibomian glands. This hypersecretion leads to an accumulation of fatty materials that that form lesions that occlude the ductal elements of the gland, leading to an encroachment of the occlusion into the surrounding tissue, which further induces an inflammatory response. Similarly, hordeola is characterized by hypersecretion of sebum from sebaceous glands. Individuals suffering from Chalazia and/or hordeola are often treated by warm compresses or lid soaps which mechanically remove the excess secretion. This approach is often ineffective. The use of antibacterial eyedrops are occasionally effective, but rarely cure the underlying problem—hypersecretion of the meibomian and sebaceous glands that causes inflammation. Patients usually undergo multiple surgical procedures to remove fatty secretions and associated inflammatory cells within the glands to effect relief. Such procedures are painful and occasionally result in lid scarring and misdirection of the eyelashes. The present invention, however, provides an improved method of treating subjects suffering from Chalazion, hordeola and cutaneous infections, comprising the administration of botulinum toxin to reduce or prevent the secretion of meibum and sebum from meibomian and sebaceous glands, respectively.
Botulinum neurotoxin, a toxin isolated from a strain of Clostridium botulinum, a deadly toxin at higher concentrations and quantities, has been used as a valuable therapeutic for the treatment of many neuromuscular diseases (e.g., dystonia, hemifacial spasm, bruxism, spasticity, cerebral palsy, torticollis), as well as sensory disorders and cutaneous disorders (myofacial pain, migraine, tension headaches, neuropathy, hyperhydrosis). Although botulinum toxin has been used for the treatment of hyperhydrosis (sweating disorders) by presumably targeting the cholinergically-innervated eccrine sweat glands, the effects of botulinum toxin on other cutaneous glandular structures, such as the meibomian and sebaceous glands is undocumented and unappreciated. Both the consequences and pathology associated with hyperhydrosis and the aqueous secretate (sweat) of the eccrine glands are distinct and dramatically different than that associated with hypersecretion-disorders of the meibomian and sebaceous glands and their lipophilic secretions. Prior to the present invention, the utility of botulinum toxin to prevent recurring chalazion, hordeola, infection of the lipid-rich glandular secretions, and decrease these secretions has been unrecognized.